الجهاز القلبي الوعائي Cardiovascular System

Over the previous 3 months, the patient felt progressively dyspneic. She used to be able to climb the stairs of her house with little problem, but now finds it increasingly difficult and occasionally has to stop halfway up the stairs to catch her breath.

She now has trouble playing with her grandchildren. She complains of extreme fatigue following 5 minutes of interacting with her grandchildren. She also describes waking up in the middle of the night with shortness of breath. She finds these episodes distressing and has to rush to a nearby window to catch her breath.

She denies chest pain, her vital signs are: temperature: 37.1 C ( 98.8 F ), pulse 74/min, blood pressure 150/94 mm Hg, On physical examination the patient becomes mildly dyspnetic on transferring from the chair to the examination table. There is evidence of jugulovenous distention and pedal edema. There is no chest wall tenderness, although there are scattered crepitations throughout the chest .

Cardiovascular examination reveals heart sounds that regular in rate and rhythm, with absence of murmurs and rubs.

What is the most accurate test?

A- Coronary angiography
B- Echocardiography
c- Electrocardiogram
D- MUGA Scan
E- Stress test